ELEPHANTIASIS, el-e-fan-ti'a-sis (Barbadoes leg; Bouc nemia), a disease dependent on lymphatic obstruction and char acterized by hypertrophy of the skin and subcutaneous tissue. Two forms are known: (1) elephantiasis arabum, due to filariasis (q.v.); (2) the non-filarial form due to lymphatic obstruction from any other cause, as erysipelas, the deposit of tuberculous or cancerous material in the lymphatic glands, phlegmasia dolens (white leg), long-continued eczema, etc. The enlargement is limited to a particular part of the body, generally one of the lower limbs, rarely both, or the scrotum, one of the labia, or the mam mary gland ; far more rarely the face. An attack is usually ushered in by fever (elephantoid fever), the part attacked becoming rapidly swollen and the skin tense and red as in erysipelas. The subcutaneous tissues become firm, infiltrated, and hard, pitting only on considerable pressure. The skin is roughened with a net work of dilated lymphatics and bullae may form, discharging a chyle-like fluid when broken (lymphorrhoea). In a later stage still the skin may be coarse and wart-like, and there is a great tendency for varicose ulcers to form. At the end of a variable time enlarge ment ceases to take place and the disease becomes quiescent, but recrudescences occur at irregular intervals, always ushered in by elephantoid fever. At the end of some years the attacks of fever cease and the affected part remains permanently swollen. The only difference in the history of the two forms of the disease lies in the fact that the non-filarial form progresses steadily, until either the underlying condition is cured or death occurs. The elephantiasis due to filaria is due to lodgment of the parasites in the lymphatics and lymph spaces.
Treatment is unsatisfactory. Occasionally the dilated lymph trunks can be found and an operation performed to implant them in some vein (lymphangeioplasty). And in some few other cases artificial lymphatics have been made by introducing sterilized silk thread in the subcutaneous tissues of the affected part and prolonging it into the normal tissues. This operation has been applied to the elephantoid arms dependent on a late stage of can cerous breast. Elevation of the limb and elastic pressure should always be tried, but often amputation has to be resorted to in the end. The disease is totally different from the so-called elephan tiasis graecorum or true leprosy, for which see LEPROSY.